HomeMy WebLinkAboutX2020-1583 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit ApplonX
Comm'1 Residential City of Newport Beach - Building Division q(xfl,�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
❑Building jJ'Grading �yDrainage (!Elec Mech C cuvdcut
/' C Plum
j Cu Yd Fill IF_
Address
9
[, Flood C� Fire C Liq E. Landslide
New/Add SFi 5 2 ZO j Remodel SF �.,1 9. j Garage/New/Add r �
OWNER'S NAME Last
jN/A Floor Suite No
Use C ConstType l
# StoriesC # Units (if Res)C
Valuation $
Material/Labor
I
Owner's Address
Owner's E-mail Address
— I
City _-_--- State ram-, Zip I TPIBntinnoF�
APPLICANT'S NAME Last
Applicant's Address
City i State
ARCHITECT/DESIGNER'S NAME
Firstl
Applicant's E-mail Address
Zip Telephoned
Last _'First
Architect/Designer's Address
City _ "--_"---_ State L
Lic. No. C—
ArchitectlDesigner's E-mail Address
Zip [— Telephone
ENGINEER'S NAME Last
First Lic. No.
Engineers Engineer's Address
Engineer's E-mail Address
City -i
----------- State 1
r — Zip �- Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. Class-
----...----- -------
Contractor's Address -----" — - -- ---- -
Contractor's E-mail Address
City State
-- ------ Zip F Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $